Editorial Comment:  Journeys

1. Journey 1:  The Staff, Senior Editor, and Editor-in-Chief of the ASAM Weeklyare honored to announce the digest’s bronze award in the category of best E-Newsletter, from The American Society of Healthcare Publication Editors (ASHPE). We have shared the task leading to this point for three years.
2. Journey 2:

In 1986 I found myself unexpectedly sober, for fully a year. In that condition, I had stumblingly worked my way back through odd jobs, ultimately to a bottom-tier emergency room night stint, at $22/hr. after deduction for malpractice insurance.  To many readers, this will ring familiar.  My employer had offered to endorse me for a civilian position in an Army occupational health physical examination center; it would be steady, mechanical, tedious, dependable work. It was the medical professional equivalent of a future washing dishes in a halfway house.  I was not discontent.

But I was apprehensive, and convinced of my own unsuitability.  As a part of the application process, conducted in a military medical center, potential civilian employees who had passed over all of the hurdles of privileging, physical examination, security and background checks, needed to conclude by trekking through a day-long check-in process. The hospital was and remains enormous, and the grounds upon which its buildings are situated consist of many parade fields and open spaces. Beginning at seven in the morning, I sat in waiting room after corridor after waiting room, sorting my papers in front of endless numbers of disinterested but civil clerks: some who could not conceal their boredom, others who were actually grateful to me for momentarily relieving it. The end of the afternoon arrived, and I, with my sheaf of mimeographed (sic) papers and supporting documentation found myself confronting the last checkbox on a clipboard thoughtfully lent to me by the most junior army clerk in the facility. He had taken pity on a doddering, clearly hopeless old man with his sweaty and grubby portfolio of cheap paper.  I was 37. In the instructions to complete the last checkbox it was noted that I would need to proceed to building 2561, situated across the campus and uphill 800 yards from the actual hospital. It had been a long day, I was hungry, and I had all of the weariness of a small child who has accompanied his mother on a shopping trip during a holiday sale. As I made my way across the field, defeatist thoughts began to percolate through my aching head, among them the growing suspicion that this would all prove to be a cosmic joke and that I would be betrayed by the last step in the check-in procedure. It was not evident from the form what would occur at my destination. As I got to the 300^th yard of my forced march, thinking to myself that it couldn’t get any worse, it began to rain, heavily.

I arrived at building 2561. It was a seemingly disused storage warehouse for commissary supplies, meats and perishables to be prepared in the hospital. Along the length of one long corridor were many steel, man-sized refrigerator doors. I was now convinced that my foreboding had been justified and that, in fact, I was not going to be able to tick off the last box. This was clearly not a place in which the business of government could be conducted. But then, surveying the stainless-steel doors, I caught sight of a piece of paper, hand-lettered, held by yellowing scotch tape on the front of one. The words on it corresponded to the legend next to the checkbox on my clipboard: “Personnel Optimization Verification Division,” I believe. It has been 33 years. 

I knocked. The door opened, and from the dusty, stiflingly hot corridor I could see inside what had once been a massive chill-box and was now a beautiful, orderly, handsomely-decorated office, complete with a sofa and coffee table and an enormous desk, easily the size of a large living-room.  Several circus and movie posters, framed, decorated the paneled walls. Holding the door open was a slender, clearly athletic, impeccably-attired Army major in class B uniform, pressed to a knife-like crease. Tanned and handsome, he had two flashes of white in his perfectly combed hair.  He held a pipe in his teeth; in those days, you could still smoke in military offices, but I don’t believe it was alight.  Perhaps it was an ornament.  He looked at me from an aspect of fully 6-1/2 feet. He silently held out his hand, signaling that I was to give him the clipboard.   “This is…the Personnel Optimization Verification Division?” I stammered, almost inaudibly.  He extracted an actual fountain-pen from his breast pocket; initialed the final box with a flourish, ignoring the sodden accompanying documents; capped his pen; and returned my precious, wet, crumpled papers to my still-outstretched palm.  “Of course,” he replied.  “You are now done.” And not unkindly, but with no further acknowledgment, he slowly closed the refrigerator door.

• W. Haning, MD